Healthcare Provider Details

I. General information

NPI: 1093139065
Provider Name (Legal Business Name): ALEXANDRA MILLER DUNHAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXANDRA MARIE MILLER

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S PACA STREET 6TH FLOOR, STE 300, ORTHOPAEDIC SURGERY
BALTIMORE MD
21201
US

IV. Provider business mailing address

110 S PACA STREET 6TH FLOOR, STE 300, ORTHOPAEDIC SURGERY
BALTIMORE MD
21201-1642
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6040
  • Fax:
Mailing address:
  • Phone: 410-328-6040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberD0097308
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: